v3.24.3
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash flows from operating activities    
Net income $ 57,709 $ 57,943
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 19,801 12,846
Amortization of debt issuance cost 1,374 711
Share-based compensation 19,301 13,364
Non-cash lease expense 3,946 5,223
Gain on debt extinguishment (2,398) 0
Unrealized (gain) loss on investments (415) 6,898
Income from equity method investments (2,887) (3,104)
Unrealized gain on interest rate swaps 0 (1,022)
Deferred tax (7,596) (3,936)
Other 8,394 0
Changes in operating assets and liabilities, net of business combinations:    
Receivables, net (37,927) (46,261)
Receivables, net - related parties (17,588) (21,801)
Other receivables (2,986) 2,303
Prepaid expenses and other current assets (7,825) (1,246)
Loan receivable, non-current 0 (40)
Other assets (2,996) (180)
Accounts payable and accrued expenses 25,866 (1,119)
Fiduciary accounts payable (1,696) (1,808)
Medical liabilities 21,517 10,108
Income taxes receivable (7,266) 25,154
Operating lease liabilities (3,611) (5,215)
Other long-term liabilities 429 109
Net cash provided by operating activities 63,146 48,927
Cash flows from investing activities    
Payments for business acquisition, net of cash acquired (115,494) (4,674)
Proceeds from repayment of promissory notes, including those with related parties 256 2,200
Purchase of marketable securities (82) (2,125)
Proceeds from sale of marketable securities 124 0
Purchase of investments - privately held (2,500) (2,000)
Purchase of investment – equity method (5,968) (325)
Purchase of call option issued in conjunction with equity method investment (3,907) 0
Issuance of promissory notes (26,000) (25,000)
Purchases of property and equipment (5,500) (21,472)
Contribution to investment - equity method 0 (700)
Net cash used in investing activities (159,071) (54,096)
Cash flows from financing activities    
Dividends paid (2,114) (2,266)
Borrowings on long-term debt 171,875 0
Repayment of long-term debt (14,750) (461)
Payment of finance lease obligations (534) (505)
Proceeds from the exercise of stock options 232 1,250
Proceeds from ESPP purchases 271 0
Taxes paid from net share settlement of restricted stock (3,975) 0
Repurchase of treasury shares (717) (9,689)
Proceeds from sale of non-controlling interest 150 0
Purchase of non-controlling interest (25) (50)
Borrowings on loans 0 3,149
Net cash provided by (used in) financing activities 150,413 (8,572)
Net increase (decrease) in cash and cash equivalents 54,488 (13,741)
Cash, cash equivalents, and restricted cash, beginning of period 294,152 288,027
Cash, cash equivalents, and restricted cash, end of period 348,640 274,286
Supplemental disclosures of cash flow information    
Cash paid for income taxes 38,270 7,881
Cash paid for interest 23,190 9,670
Supplemental disclosures of non-cash investing and financing activities    
Fixed assets obtained in exchange for finance lease liabilities 152 0
Right-of-use assets obtained in exchange for operating lease liabilities 13,303 6,626
Common stock issued in business combination 21,952 0
Common stock issued for contingent consideration payment 4,023 0
Tax impact from APC dividends to APC Shareholders 0 3,076
Draw on letter of credit through Revolver Loan 4,732 0
Reconciliation of cash, cash equivalents, and restricted cash    
Cash and cash equivalents 347,994 273,941
Restricted cash 646 345
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows $ 348,640 $ 274,286

Source

10-Q PDF
XBRL